Stephanie Nichole Gonzalez

Individual provider Active NPI Pediatric Nurse Practitioner · Linthicum Heights, MD

NPI 1992378053 · NPPES record last updated Apr 18, 2024

Key facts

NPI
1992378053
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
R204398 (MD)
Practice address
605 Global Way
Linthicum Heights, MD 21090-2222
Phone
(410) 789-7337
NPI assigned
Jul 19, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R204398MDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: stephanie.harwell.2@26214.direct.athenahealth.com
  • Direct secure messaging: stephanie.harwell.1@7466.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R204398 MD Yes

Addresses

Primary practice location

605 Global Way
Linthicum Heights, MD 21090-2222

Mailing address

105 Amesbury CT
Severna Park, MD 21146-1222
Phone (410) 440-5043

Other providers in Linthicum Heights, MD

All providers in Linthicum Heights, MD · Pediatric Nurse Practitioner in Maryland

Sources for this page

Verify at the official NPI Registry.